The Spine Journal

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(2014)

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Pott disease A 21-year-old Senegalese man came to our attention complaining for 6 months of lumbar pain extending to the left inguinal region and the anterior surface of the thigh. Radiographs showed a thoracolumbar scoliosis, T12–L2, with the apex at L1 and reduction of height of the T12–L1 and L1– L2 discs (Fig. 1). Blood tests revealed white blood cell and C-reactive protein elevation. A magnetic resonance imaging confirmed the diagnosis of spondylodiscitis and showed the presence of pathologic tissue invading the spinal canal from the vertebral body of T12–L1 (Fig. 2). Computed tomography scans show a huge paraspinal abscess involving the left psoas muscle, typical of Pott disease (Fig. 3). Microbiological tests confirmed the diagnosis. Antituberculosis chemotherapy was initiated. An anterior debridement, bone grafting, and fusion with titanium Harms cage followed by a posterior transpedicular stabilization was performed (Fig. 4). Matteo Formica, MDa Luca Cavagnaro, MDa Carlo Formica, MDa,b a Clinica Ortopedica University of Genoa IRCCS A.O.U. San Martino Ist Largo R. Benzi 10, 16132 Genova, Italy

Fig. 2. Magnetic resonance imaging shows the presence of pathologic tissue going into the spinal canal from the vertebral body of T12–L1. b

CVCO, IRCCS Istituto Ortopedico Galeazzi Via Riccardo Galeazzi 4, 20161 Milano, Italy

FDA device/drug status: Not applicable. Author disclosures: MF: Nothing to disclose. LC: Nothing to disclose. CF: Nothing to disclose.

Fig. 1. X ray films show a thoracolumbar scoliosis, T12–L2, with apex in L1 and reduction of height in T12–L1 and L1–L2 discs. http://dx.doi.org/10.1016/j.spinee.2014.11.006 1529-9430/Ó 2014 Elsevier Inc. All rights reserved.

Fig. 3. Computed tomography scans at L4 level reveal a huge paraspinal abscess involving the left psoas muscle as a typical sign of Pott disease.

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M. Formica et al. / The Spine Journal

Fig. 4. Surgical treatment consisted in a first anterior debridement and fusion with titanium Harms cage and screws, followed by a posterior transpedicular stabilization.

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(2014)

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Pott disease.

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